Birth Trauma Round Up

I've been meaning to get around to this for awhile. Each day when I read news articles and blogs, I'll bookmark it if its something I want to come back to or if I have something to say about it, or agree its important and needs to be said again and again until the right people listen. Generally, the articles that stand out to me are on the topic of birth trauma. So here is an anthology of birth trauma related articles over the past few months. On analogies: Keyboard Revolutionary: An Interesting Parallel

So what does it mean when another wielder of authority says, "Do what I say or your baby will die"? Are they looking out for your best interest....or are they a bully, a rapist, an abuser, deliberately playing on your unignorable instinct to protect the ones you love in order to get what they want from you?

And when its seen like this, how obvious is it that a mother can come away from her birth experience with PTSD?

Raising My Boychick: Just Like Athletics: Exploring a Childbirth Analogy

Rather than coerce with stick or carrot, what we do in athletics (again, thinking especially of charity racing; a particularly apt comparison to birth as it is physical effort that benefits another) is cheer, support, encourage, commiserate. No one stands at the sidelines of a charity marathon yelling “give up! it’s not worth it! stop trying to be a martyr! you’re not going to win a medal!” Nobody whispers in their ear when they’re doubting, “take these drugs [that will actually make running harder], let us drive you to the finish [we'll tie you behind the car], finish in five minutes or we’ll whisk you away for surgery [for a torn ligament you don't actually have].” No one tells an athlete she can only have a “trial” of running if she has no food or drink, if she’s hooked up to machines that purport to measure how hard her muscles are working, that take her blood pressure and heart rate and temperature and send it all to the medics’ station and meanwhile are hindering her movement and reminding her she’s on a clock and she’s not running fast enough (or running too fast and they’ll “have to” stop her “for her own good”.

The analogy works well. What would happen if hospital birth attendants had this analogy called to their attention? It seems so simple, yet a strong paradigm shift is engendered in it.

On feminist activism:

Courtroom Mama: Feminism Behind the Veil

[How many women] suddenly realized that grown-ass people in a medical office were calling them “mommy” and telling them what to do as though they themselves were children. And the fact is, for a number of women of relative privilege (cis-gendered, heterosexual, middle-class, etc.), the journey into motherhood might very well be the first point of friction with patriarchy. Many of us lucky enough to not feel the weight of oppression can manage to skate by with just our carryon baggage, but add a pregnancy or a child to the mix, and suddenly you’re “actually” a woman, or rather “just” a woman.

Fertile Feminism: Mainstream Feminism and Motherhood

That’s why I’m so pleased to have discovered all the feminist mother blogs that have been springing up recently, and why I want to work with feminist mothers to help bring your voices and battles and mainstream feminism together. It’s been all too easy for childless feminists to ignore motherhood, and it really, really shouldn’t be. We need to listen, learn and become allies to mothers by not only centring your voices but using our own to advocate for mothers everywhere.

The previous two articles both discuss how stereotypical feminists (or rather the dominant cultural idea of feminism) doesn't understand the issues facing mothers in dealing with injustice in maternity care. It now appears that some "majority" feminists are becoming aware of what us feminists in the minority are facing. Like Courtroom Mama, my first run-in with patriarchy may very well have been in my first birth experience and it certainly played a large part in coming to self-identify as feminist. I too felt, before birth trauma, that feminist history afforded me a "post-feminist" spot in my world.

On cruelty:

Henci Goer: Still Cruel Maternity Wards

We have a culture of impunity in maternity wards. Once pregnant, a woman effectively cedes her right to autonomy and bodily integrity to obstetric staff who sometimes—on grounds of fetal welfare, self-protection from malpractice suits, or mere convenience—manipulate women into compliance in ways that would be considered fraud in any other venue. Without fear of being called to account for it, they can bully, coerce, humiliate, and threaten. And, yes, they can physically mistreat or even sexually assault them

It is this that needs to be exposed. In her article, Henci links to recent news stories that highlight some of these abuses. Its starting to be uncovered but it still seems to far-fetched so far from the norm, but then what is normal seems irrelevant because of its normalcy. It seems the media has not just captured the sameness of these outrageous cases with the outrageousness of the "normal" cases. The whole history of hospital birthing has been this way and its just sick.

The Unnecesarean: Women Have Right to Complain about Mistreatment During Birth

I really believe that someday, our daughters or granddaughters will be amazed that any woman was ever arrested for refusing a c/section, or operated on against her will, or prevented from moving or eating or making noise while she labored to birth her baby. They’ll regard much of what is still considered normal today as cruel, and uninformed, and backwards. And they’ll be right. But only if we keep refusing to be silenced.

It exactly this that I could not and would not believe before I contemplated becoming mother. It seemed so blatantly wrong that it seemed impossible that it could be indicative of systematic injustice. It really did feel like just being pregnant and giving birth that I was going into a dark and dirty underground system. ACOG has been labeled a cartel and for good reason.

Amy Romano @ Science and Sensibility: Patient safety, disciplinary action, and the marginalization of midwives

But whether disciplinary action is against midwives or physicians, is punishment the best way to deal with breaches in patient safety?

When this question is posed to someone who has experienced birth rape, the answer is: They have to held accountable somehow. If its not through a hefty check from their administrators, then it needs to be some censuring from their superiors. If not that, then it needs to be criminal charges. When a woman is feeling like her OB or midwife is entering her body with the same force and skillful manipulation of a rapist, yes, the provider must be held accountable. RH REality Check: The Cure for An Ailing Maternity Care System

The idea that maternity care should be evidence-based, safe, and efficient seems like a no-brainer but one key goal to note is how these imperatives lay the groundwork to minimize “overuse, underuse, and misuse of care practices and services.” We need to make sure we’re providing optimal care to all women by guaranteeing women are able to access the services they need if they need them. However (this is a big one), let’s also start from a place of understanding that pregnancy is a healthy state of being – not an inherently sick state – and so let’s also minimize the amount of unnecessary interventions that now drive up costs and place women and newborns at risk for poorer health outcomes.

It must be said: the "overuse, underuse and misuse of care practices and services" are causing trauma to new mothers, rendering it exponentially more difficult to care for their babies in their early years. Its not yet known what sort of long term effects can be had from a traumatized mother in early life, but there are studies that show that children of depressed mothers are more likely to experience depression, children whose parents experienced PTSD are more likely to experience PTSD after a potentially traumatic event. Are our children being hardwired to face life's challenges with disorder? Its not just about health care costs, its about a mother's sense of confidence in her ability to care for her children. Its about the baby's sense of being cared for and loved. Michel Odent equates these early unnecessary challenges to a threat to humankind. He even poses the question "Can humanity survive?"

Its starting to sound pretty melodramatic and that's exactly what I would have labelled it before my experience, and before I learned that I was not alone. I find its a coping mechanism to write in this manner and that I cannot be objective and unemotional when I read the stories of birth trauma at Solace for Mothers and the MDC birth trauma board. Some of it seems so fundamentally, viscerally wrong that I struggle to articulate how and why it is so wrong. So instead, I try, though my blog to illustrate, highlight and show case examples so it can become clear to others without my feeble attempts to spell it out.

What Trauma Looks Like

Warning: this post will be triggering for birth trauma survivors

Make an on-line slide show at www.OneTrueMedia.com

When watching this video, I was reminded of the pictures taken of me holding my babies for the first time after their births. They are starkly different. I've pondered over the differences before and now that I've seen this video, I feel like posting the photos to illustrate to others what trauma looks like.

After a traumatic birth, described as birth rape:





























The joy at meeting my baby comes through (and a sense of my victory over the system's efforts to control me), but look at that far away stare showing the disconnect between me and my baby. And do you see the timidity and the reservation with which I'm holding my baby boy? And how the smile doesn't make it to my eyes?

When my son looks at pictures from his birth, this is what he is going to see. I hope he never questions because of these pictures, "Why is my mama sad? Did she want me? Does she love me? Is she mad at me because of how I was born?"








And then compare, to this:









From this, and another example from a friend's blog, I see that birth experience matters. Not to the mom's hedonistic desire for self-satisfaction, but to the baby that the mother greets. I feel my babies deserve to be greeted by a mother who feels victorious, respected, capable and empowered; not one who has been victimized, disrespected, dehumanized and demeaned.

Not Letting it Happen to You Can Lead to PTSD

The blogger at Nursing Birth posted last year a series called "Don't Let This Happen to You: The Injustice in Maternity Care Series" and in one of the posts, she described a phenomenon that I had never heard about, but recognized it immediately as what was attempted on me when I was pregnant with Willem.

In my prequel, I described how at 37 weeks 6 days, contractions started at 11 pm. At 11 am the next day, I was 3 cm dilated having contractions every 6-15 minutes. The midwife at a prenatal appointment that day told me that I was in labor and should check in with Labor and Delivery to be admitted to the hospital. The midwife on call at Labor and Delivery called failed to progress and, after performing cervical exams every hour for 4 hours ,started advocating for pitocin/AROM augmentation as she called it. It was 9 pm, 3 to 3 1/2 centimeters dilated with contractions between 6-10 minutes apart.

In the prequel, I asked if this sounded like a phenomenon that you've heard of before. Do you know?

Nursing Birth taught me that this is called a backdoor induction and she defined it this way:

If a woman is 4cm dilated but is not having regular, noticeable, and painful contractions that are causing cervical change she is NOT in labor. If said woman is sent into the hospital and any interventions to stimulate contractions are started, then it is by definition considered an induction NOT an augmentation. And if said patient was not scheduled to be admitted on such day, then it is considered a backdoor induction. I knew it as soon as I read it. This is what happened to me. It is unethical and just as Nursing Birth calls it, an injustice perpetrated on a birthing woman.

Even at the time, I knew it was inappropriate for labor to be stimulated artificially and I refused. This is where my story and Nursing Birth's patient's story begins to differ. I did not go along with it with the recommendation for induction. If I had been more savvy to manipulative tactics such as this, I would have known to not trust the midwife who referred me to L&D. But then again, if I had been more savvy, I would have known that hospitals are not the appropriate place for low-risk mothers to give birth in the first place. Even then, we weren't understanding why the midwife would make the recommendation to check into the hospital obviously in early, non-progressing labor but in our excitement, we decided to trust her. To our detriment.

Because in my experience, I then learned what PTSD is like. I'm not faulting Nursing Birth for leaving the story off as she did, but I have something to add to it. If you fight the system, even if you win, which is not likely or common, you will still lose. You will lose a sense of being human, the feeling of being respected and treated like the person deserving of dignity that you are. Such dehumanization can have indelible impact on the psyche.

The converse is true, letting it happen to you, can lead to PTSD. But not knowing it is happening to you seems to be a protection. It appears to me that the mother, Jessica, in the story was unaware at the unsavory practice that she was being subjected to. So what is worse? Not knowing you've been victimized, or knowing the feeling of violation because you do know you've been victimized?


........

After I had begun to process my birth experience, I wrote an email to the referring midwife telling her the outcome from her recommendation. To my surprise, I received a conciliatory email in response.

After I learned the term backdoor induction, I was upset for a couple of days. I talked through it with my colleague from Solace for Mothers and felt better sharing the stress with someone else. Since, I've intended to blog about it, but I'm only finding myself able to do so after writing the prequel and being triggered by the previous article I wrote about.

Sharon with Solace for Mothers asked me the question, "What are you now going to do with that knowledge?" I answered that I would write a letter to the hospital saying I knew what they did and emphasize how distasteful and unethical the practice is. I have not done that yet, because I'm struggling to find the words to express how and why that is so wrong.

So, I'll ask my readers, after telling my story in a letter to the hospital and midwifery supervisor, how do I support my claim that practicing backdoor inductions is an unethical practice?

What Triggered the Prequel

My post from last night, The Prequel of my Traumatic Birth Experience, was prompted by a friend posting this article on facebook. Though it is reporting a study saying that that anxiety in pregnancy can predict developmental delays in the baby once born, my attention was drawn to this paragraph:

"Contrary to old beliefs, however, research shows that ordinary day-to-day job and home stress isn't likely to cause low birth weight or other problems for most women. Traffic delays, work deadlines and other everyday hassles aren't likely to pose a threat to unborn babies, researchers say, and pregnant women who feel they are coping well tend to do just fine."

I disagree with this statement based on my experience (copied from the prequel):

When I was in week 34 of my pregnancy, I was working part-time at a preschool (9am-1:00 pm each day). I had a commute and prep time before class started so I was waking up at 7 am. I'm not a morning person (if you ever notice when most of my blog entries are posted you'll know that I'm a night owl). I was constantly tired in my pregnancy. I'd get home from work and have to take a long nap each afternoon just so I could function the next day. One day, I had to rush away from work for a prenatal appointment, but that day had already been a struggle. I was fighting nausea the whole day (strange for the third trimester) and had thrown up 3 times, once as I was getting into the car to head to the appointment. Already feeling tired and sick, I encountered unexpected traffic which was making me late to the appointment. I generally get very stressed when I am late to something so the combination of being impatient, stressed sick and tired was not boding well for that appointment. I then parked rather far away from the clinic and had to walk (more like jog since I was worried about being so late).

I also remember there was a journal article that linked maternal employment in late pregnancy to increased blood pressure. The researchers of the study being discussed in The Wall Street Journal either were unaware of this study published in American Family Physician in 2001 (Increased Blood Pressure and Working in Late Pregnancy. American Family Physician Oct 2001), not considering increased blood pressure as a "problem" for women, or had reviewed the findings of that study and disagreed with its findings.

To me, my experience leads me to support the findings of the 2001 study. Even though, I was incorrectly diagnosed with pregnancy induced hypertension at that appointment, it is true that my blood pressure was elevated from my baseline (diastolic at 88 after that stressful day, but its 60 when not pregnant, and at 70 when pregnant).

Reading the Wall Street Journal report last night brought that all back. Even at the time, my husband and I ascribed my working, the stressful commute and the brisk walk to the increase in blood pressure. I still do not understand why the midwife was not willing to accept that as a possibility. We felt it was lunacy to then think that rechecking my blood pressure later in the appointment, AFTER diagnosing me with gestational diabetes, putting my on bed rest and leading me to believe I was experiencing PIH, was going to result in a lower blood pressure reading, because I had time to "relax" during the appointment!?!

That was precisely the time when I stopped feeling like I could enjoy my pregnancy. Up until that point, I had felt very excited and happy as the birth approached. After that appointment, that happiness was clouded by the specter of the dead baby and dead mother card, as well as an induction that I knew made a cesarean more likely, which increases the chances of complications and death. All of this then caused greater confusion in my mind because at the beginning of my pregnancy, I was given a priesthood blessing by my husband and adopted father in the gospel which told me that I would give birth and go through the pregnancy without complications. Given what my husband and I knew, we believed the blessing was still true because the midwife was mistaken in her diagnosis. But how to handle a situation with a maternity care provider where our version of reality didn't mesh with hers? It all added up to a great deal of stress in our minds and just paved the way for the trauma I experienced as a result.

I often think that if the birth experience had happened in isolation of the prior stress, I wouldn't have experienced PTSD to the degree that I had. As it is, I felt there was so much manipulation and lies that I knew I wasn't safe going into labor so my stress response to what was happening in the hospital was amplified.

Review of Birth as an American Rite of Passage

I just finished reading "Birth as an American Rite of Passage" and I found myself wishing that if I had read just one book to learn about what giving birth in an American hospital would be like, I wish this book written by medical anthropologist Robbie Davis-Floyd. Through the words of women in response to interview questions relating to their birth experience, readers get a very realistic view of what obstetric culture is like and the expected role of women birthing in hospitals. I often said that if someone had told me what giving birth in a hospital is like based on culture, medical ideology, current practices, etc., I would not have believed them because it all sounds so very irrational, paranoid, conspiracy-theorist and unethical. However, after reading "Birth as an American Rite of Passage" I think I would have been convinced through Davis-Floyd's analysis and the selected quotes from women's birth stories. She clearly describes the "technocratic model" that predominates our current culture and how it renders women as objects who malfunction who are not to be trusted and who threaten the very premise that our world can be saved by technology.

In the article I recently wrote for the Exponent, I quoted the author's definition of technocratic birthing rituals and I'll also include it here:

“The term technocracy implies use of an ideology of technological progress as a source of political power. It thus expresses not only the technological but also the hierarchical, bureaucratic and autocratic dimensions of this culturally dominant reality model—dimensions that are immediately visible in many realms of post-industrial American life.”

Davis-Floyd goes on to state:

“According to the technocratic model of birth, the human body is a machine. The medical system [which is inculcated by the technocratic culture] has done a thorough job of convincing women of their defectiveness and dangers in their specifically female functions”—pregnancy and childbirth foremost.

Through reading the book, I've also come to have a greater understanding of why women are so steeped in our culture and why non-technocratic birth is unlikely (as 98% of women in the US give birth to babies in the hospital, and only 1% birth at home). Indeed, when as I became a mother, I too felt the obligation to follow the dominant culture. If only I had know the historical underpinnings of hospital birth and read this book, I may have been able to be convinced that birthing in a hospital was not the way I wanted to welcome my child into my arms.

I was pleased to read that Davis-Floyd recognized and named trauma as a result of birth experiences; however, the symptoms of post-traumatic stress disorder were misidentified as mild postpartum depression. In my research on PTSD resulting from childbirth, the earliest citations I have found declaring the diagnosis of PTSD were from 1995--before the first edition of the book was published. However, I am disappointed that in the revising for the second edition, the author did not update sections on trauma to reflect the new diagnosis.

Also I felt a category of women's experiences was missing. Davis-Floyd stated that of the 100 women she interviewed for the book that women either fully accepted and embraced the technocratic model of childbirth, they rejected it entirely or they were somewhere in between. To give the benefit of the doubt, there is a chance that the reason why my missing category was not included was because none of the women in her sample would have matched it. The in-between categories included:

• Women who maintained conceptual distance from the technocratic model by achieving "natural" childbirth in the hospital (15%)
• Women who maintained conceptual distance from the technocratic model by placing technology at the service of the individual (10%)
• Women who found conceptual fusion with the technocratic model with cognitive ease (42%)
• Women who found conceptual fusion with the technocratic model during birth by experiencing cognitive distress, e.g. trauma (9%)

And now, because you are wondering what this missing category I am referring is: I feel she left out, or did not have a woman in her study matching the profile, of a women who maintained conceptual distance from the technocratic model by achieving "natural" childbirth in the hospital with cognitive distress.

For this was my experience, I was able to attain the ideal unmedicated, low-intervention birth in a hospital and the detriment of my mental health.

Perhaps it could be argued that my experience would fit into the last category of finding fusion with cognitive distress, but I did not find fusion. And if someone wants to state that I did, because I consented to AROM at 5 cm, I'm not listening...

An interesting correlation can be mentioned however, that the percentage from Davis-Floyd's study of women who experienced cognitive distress is the same commonly cited percentage rate of PTSD after childbirth--9%. Making her omission of PTSD as a sequelae of childbirth, even more disappointing.

So in conclusion, this book is a very persuasive case for birth as a initiation rite for women as they transition to motherhood and current obstetric practice as a vehicle for gaining compliance and reinforcing the dominant cultural view of technology reigns supreme. If I were to create a list of influential, informative books for future mothers, this would be near the top.

To end, a quote from the book that summarizes why birth is so exceptionally profound and important to me:

Her baby constitutes for her a powerful symbol of her motherhood, her individuality, her new family, the beauty and wonder of nature, and the perfection of her own body and her procreative powers.

Bound and Gagged

In a dark room with no windows,
a drug coursing through my veins
that left me bound and gagged.

I lost my mind and coudln't move.
I was no longer myself.
I was lower than dirt.
A wounded animal to be put to sleep.
I heard whispers of "just put her out of her misery."
"Get that thing out of my sight. I can't deal with her now."

Locked in a room.
I heard my screams in my head, but I couldn't get them out.
A terrible nightmare but with the crashing, debiltating knowledge that this was reality.

Powerless to stop the penetration.
Unable to resist orders.
Catatonic and numb.
Unable to move.
No where to run since my legs were tethered to their place.

The torture ensued.
My body defiled, and abused.

I lost all power.
All determination and will.
If coherent speech had been an option,
the thoughts were drowned out by the screams of my mind.

Then it was all over,
the drugs had worn off.
The figurative bounds released.
And I was torn and broken, discarded and pushed aside.

Down the hall, I hear a distant
"Next!"

ANNOUNCING: Solace for Mothers Online Community

Since Willem's birth, I have been looking for ways to prevent and help other mamas who have been traumatized by their birthing experiences. I am pleased to say that I've been able to partner with Jennifer Zimmerman, a mother who experienced a traumatic birth 3 years ago, and Sharon Storton the excutive director of Solace for Mothers to create an online community for women suffering the effects of traumatic birth.

Here is the official announcement:

This message is to announce a new online discussion board called Solace For Mothers, An Online Community For Healing Birth Trauma. It is for women who have experienced trauma around the process of giving birth. For these women, giving birth has left them feeling deeply disappointed, traumatized, or even violated. We want these women to know that they are not alone, that birth trauma is very real, and that other women have had similar experiences and feelings. We have created an online community as a place for women to begin or continue their healing journey.

In the online community, there are different categories and forums, and the topics covered are issues that often come up for women dealing with birth trauma. It is our hope that women can virtually support each other on their healing journeys in this online community, and perhaps eventually connect with each other in the real world if they choose.

There is an introduction page here; http://www.solaceformothers.org/forum.html, and from this page you can register for the discussion board. Due to the very personal nature of this subject, we have made an effort to keep this community private, and women must register before being able to enter or view posts. If you do not fall into the category of a woman suffering from birth trauma, or if you would like to see a preview of the community before joining, you may visit this link to do so; http://www.solaceformothers.org/preview.html. This link is not the actual community and you will not be able to view members' posts from there, it will simply give you an overview of the topics covered.

We are sending this message out via email and posting it to online communities and to lists in order to reach these women. Please send this message to anyone who you feel may benefit from it.

Sincerely,
Jenne Alderks and Jennifer Zimmerman
Creators and Moderators of the discussion board

Supported by Sharon Storton and the Solace For Mothers team

A Mother's Birth Rape

Last week I wrote about recognizing birth rape and how it is an accurate way of describing some of the treatment that women experience when birthing babies in hospitals and with professional birth attendants.

This week, I was sickened when I read an account of one of the worst (or best, depending how you look at it) examples of birth rape. Warning: some graphic detail that left me feel utterly repulsed by this doctors actions.

The mom will remain anonymous for her privacy. During the homebirth of her child, she realized that she needed some extra support when she reached the pushing stage of labor. She decided to transfer to the hospital to find that support. Upon transferring, she encountered an agressive OB. Her story continues as follows:

This doctor yells for me to stop pushing and get on the bed. I tell her no, and she yells for the EMT guys who are still in the hallway to help get me on the bed. I give in rather than be manhandled. Another contraction hits and I push, and of course, baby’s crowning. She (doc) yells at me to stop, grabs that nasty betadine stuff and starts scrubbing me, then literally throws a cup of mineral oil over my crotch. My husband and kids walk in then, just as L’s head pops out. One more good push, and there’s her body. I start to say, “give her to me,” doc yells, “THICK MEC,” and cuts the cord before I can even finish saying it. They had her off, and I demand for her not to be suctioned. Believe it or not, they listened. However, at this point, doc grabs the cord and starts yanking, and says that the placenta is having a hard time detaching, and I need to push. I give a tiny test push, and know it’s not coming, so I tell her NO! STOP PULLING! STOP! STOP! STOP! I’m screaming by this point, because she’s pulling with all of her might. I grab my belly where I can still feel it attached and beg her to stop, telling her it’s attached, STOP STOP STOP! My husband is saying the same thing…then it comes out. She tries to pull it away, but I scream at her again. She then says “Your placenta looks odd. You may have had a collapsed fibroid come out with it.” At this point, I’m getting tunnel vision, and a ringing in my ears, and say that I’m gonna pass out. You guessed it, this bitch has pulled out my entire uterus.

Aside from gross medical negligence, this is the essence of birth rape--a woman who is not consenting, in fact yelling NO, STOP, exactly like a rape victim, when a doctor continues to perform an procedure or action that is inflicting more pain, above and beyond the pain experience during a nonmedicated birth.

The mother almost died from losing over 3 liters of blood, and was lucky that the doctors who performed emergency surgery were able to reinsert the mother's uterus. Hopefully, she will be able to have another child and she will heal physically.

Knowing my own experience of PTSD after chilbirth, I would be very surprised if this mother does not experience extreme PTSD symptoms and will face an emotional recovery very similar to that of a rape victim. I pray that she is able to emotionally cope with her experience and gets the support and love from people that she needs.

A sickening this about this story, is that this is an extreme example, but similar things--performing procedures without the consent, in fact inspite of their refusal-- are being done to women EVERYDAY by doctors and midwives, who then turn around and act like they saved the mother's life (paraphrased from mother's birth story).

The mother states that she intends to not let the OB get away with that treatment and intends to pursue legal action and file formal complaints against the OB.

Updates report that, "It turns out there were two things that occurred simultaneously when the doc put traction on the cord. 1) the uterus was inverted, which was not in itself life-threatening, 2) the placenta was yanked out, which caused significant bleeding. They took her to OR because the doctor who pulled the uterus out high-tailed it out of the room, and they took her to OR for general anesthesia. She was not, however, cut open (thank God). They just pushed her uterus back in there. She later received two units of blood to cover what was lost in the placenta removal. She's in some pain, but is moving around well, and there doesn't seem to be any major future implications re her uterus."

Damages Granted in PTSD after Childbirth Case

I have wondered if there is a legal precedent of a case where a woman successfully sued a doctor or hospital for malpractice and medical negiligance that caused Post Traumatic Stress Disorder in the patient. I would like to take my case to court in an effort to bring awareness to birth attendants, health care providers and the public that doctors are abusing laboring women in their care. Women's personal dignity and privacy is being impinged upon, as well as their patient's right to informed consent is being violated. Women are then suffering mental anguish, sometimes on top of a physically debilitating recovery. This is not an issue about alive and healthy mothers and babies, but its a human rights issue where women are being subjected to forms of torture and rape at the hands of their "care" providers.

In Meader vs. Stahler and Gheridian, $1.5 million was awarded to a family after a women suffered PTSD after an unneccessary C-section which she was coerced into by her doctors. Her lawyers argued that the doctors violated her right to informed consent and their negiligance in turn caused her months of agonizing physical and emotional recovery.

An article written about the case in Forensic Psychiatry and Medicine states:

Thus, it was not simply the physically disabling consequences of the surgery, but the loss of personal decision-making power concerning her body, her health, and the birth of her child, that caused Meador to suffer from Post-Traumatic Stress Disorder. Similarly, her husband's experience of loss of consortium was exacerbated by the physicians' failure to consult him to interpret his wife's wishes during labor. Instead of having participated in a true informed-consent process, he was left to feel powerless and helpless. In this way, forensic psychiatric testimony established a persuasive causal link between the lack of informed consent and the physical and emotional damages suffered by the patient and her family.

So there's my precedent! If a lawyer were to take on my case, he/she would be able to use Meaders case as evidence that others in our society and judicial system have viewed PTSD afterchild birth as a preventable condition and poor outcome caused by doctors who are not doing their jobs correctly. It was just that which lead to me experiencing PTSD after birthing in an abusive, manipulative hospital environment.

The above cited article goes on to discuss the relationship between informed consent and managed care (remember that labor care in hospitals is called aggressive management). It states that malpractice litigation based on violations of informed consent will become more frequent as medical care becomes more managed. The article mentions that "physicians may also be held liable for failing to inform patients about the conflict of interest they experience between their duties to patients and the dictates of managed care."

It was that conflict of interest that I encountered, where the manipulative and coercive treatment I received to convince me to either leave the hospital or consent to procedures against my wishes was done with the intent to clear the labor and delivery room faster so other patients (and their money) could come in, and in turn the hospital wouldn't be "wasting" money on me holding up their room.

A publication is currently being drafted by the American Medical Association that asserts that"physicians must serve their patients' best interests regardless of financial incentives." And if they do not, physicians can be held liable for damages.

The Accomplice to My Shame

I realize now.
I live in a climate of willfull ignorance, refusing to be aware.
Instead, hiding behind my excuses.
"I didn't know."
"I was just doing what I was told."
But now I know.
I will not do what I'm told.
Because what I was told is not right.
The abuses against the vulnerable,
the women heavy with new life,
ought to be called crimes against humanity.
But now I know,
I'm not the victim.
I am an accomplice.
With that knowledge, a bitter, revolted wave washes over me.
I cannot have peace knowing this is what I did to myself.
My own refusal to be more aware, to find what I needed to know--
Its out there, because I've found it now--
has made me the unknowing partner in the abuse
that left me damaged and weak.
After the hurt, I had a choice.
I could have desired to not know.
Never to acknowledge my part in it.
I could have blamed everyone else besides me and say,
"I was victim to my circumstance. They were wrong and I couldn't have known."
And then become a self-indulgent coward.
Participating in the type of cowardice that makes it possible for people to allow and participate in all the injustices and crimes of the world.
Perpetuating abuse by turning a blind eye.
But I learned.
Choosing to be unaware of another's suffering,
even my own, is no excuse for inaction.
I cannot chose willful ignores that exonerates me from culpability,
releasing me into a stupor of cowardice and irresponsibility.
I am facing the part of my blame.
Taking responsibility for my ignorance and inaction.
With this insight, I can choose to not be a victim again.
I will not let that abuse happen to me
And will work so that it does not happen to others.
I am aware. Now I know.
I will no longer be an accomplice to my shame.

This is another poem inspired by the text of the Gospel of Mary Magdalene and the commentary of it written by Jean-Yves LeLoup. The text of the gospel is as follows:

Then it entered into the third climate
known as Ignorance.
Ingornance inquired of the soul:
'Where are you going?
You are dominated by wicked inclinations.
Indeed, you lack discrimination, and you are enslaved.'

I feel that consquence of PTSD after childbirth, was in large part caused by my wicked inclination to avoid responsibility for the birth my child and hand it over to those who would take the responsibility upon themselves who for fear of culpability and litigation would act conservatively and agressively when treating my pregnancy and child. I did not have or did not seek out the discrimination (another word being discernment)to learn what my responsibility and role in birthing my child would be. I had false assumptions of my responsibility, my provider's responsibility and the roles we could play respectively. Because I did not take the time to make myself aware of the realities of birthing in a hospital environment, I became enslaved to their policies, their time schedule, their need to clear beds out quickly. And because of my ignorance, which is some ways could be labeled willful, I became one of the causes to my hurt. In the end, I was an accomplise because I did not seek out the information to make more appropriate decisions.

After my child's birth, I turned to research and publications about appropriate labor support and found that the information was out there that would have told me to avoid the controlling, rigid hospital environment for the birth of my child. I found that information after the fact and realized I hadn't educated myself and take the responsibility I needed to in order to prevent the abuse that was perpetuated against me. Of course, I know better now, so I can make different choices in subsequent pregnancies. I also have a level of empathy for other women who may have experienced similar feelings of rape, and control over their bodies in a sensitive and vulnerable time.

The experience also gave me an understanding of the power of God to create and bring forth life, the love he has for his children, and the awesomeness of life and existence. I have increased faith in God's processes of how babies are born, and the inate ability of the women of God to birth babies in love, gentleness and joy, all the while, experience the stuggle and labor of childbirth. The act of birthing a child is so very awe inspiring with the contradiction of love and joy in the midst of pain, and struggle. It is a real world example of the principle of the gospel states that we must know pain and suffering to understand happiness and joy, or else remain in total innocence knowing neither.

The Fruit of the Tree of Life

I walked through wide open fields, mists of fog, along a flowing river,
until I came to a path that ran straight and true.
Culminating in a hill topped with a tree,
laden with heavy fruit.
It was pure and ripe, full of sweetness in its plump rosy flesh.
Delicious to the taste, desirable above all other fruits.
The fruit therof promised new life, full of wonder.
Ripe for the picking.

As I looked across the expanse of the hilltop,
I saw families gathering.
Fathers supporting mothers who like the tree were heavy laden and round.
Children watched as the process of new life unfolded before them.
Mothers leaned into their husbands,
and clinging, found support from a rod of iron leading to the tree.
A few looked distracted, their attention pulled from their task.

I followed their gaze to a large building off in the distance.
From the windows of the building, women leaned jeering with IVs in their arms.
Others, bedridden, looked from their beds to the women under the shade of the tree and scoffed.
Orderlies and attendants in white and shades of blue, hands covered in latex, mouths obscured by masks, too assumed the manner of mocking those beneath the tree.

The ashamed left their pleasant spot and found the path to the spacious building
where they joined the ranks of IV inserted, bed ridden, hermetically garbed.
There they were cut open, blood pouring from their wound. The pure fruit of their womb stained and bloodied.
Once sutured, they were expelled from the building in shame and hurt.
Then drowned in the depths of their sorrow.

While those undeterred by the jeers and mockery, birthed their babies in bliss and security.
And truly came to know the deliciousness of the fruit of love.

Finding my Niche: Volunteering with CIMS

Since my initiation to birth activism after the traumatic birth of my son, I started searching for my niche in the birth community. The order of activities I considered was midwife, then doula, then Trust Birth facilitator, researcher, blogger, donor to birth advocacy organizations, Birth Network facilitator, website administrator for a maternity care rating system, and support group leader for women with PTSD after childbirth. One by one, I evaluated the resources and ability I had to do those activities; knowing I couldn't do all of them and be a mom, and a wife and a graduate student. I chose to do what I could in the meantime and that's when I started this blog. Someday, I may pursue more specialized training in the area but I'm aware that this is not the right time in life for me to do so. Then I discovered the Coalition for Improving Maternity Services (CIMS) and decided to work as a volunteer with them.

CIMS is currently working on the Transparency in Maternity Care Project, also known as the Birth Survey. This is what the website says about the purpose of the project:

We believe that women of childbearing age must have access to information that will help them choose maternity care providers and institutions that are most compatible with their own philosophies and needs. We hope that the Transparency in Maternity Care Project will provide information that will help women make fully informed maternity care decisions.

At the heart of the project is an on-going, online consumer survey, The Birth Survey, that asks women to provide feedback about their birth experience with a particular doctor or midwife and within a specific birth environment. Responses will be made available online to other women in their community who are deciding where and with whom to birth. Paired with this experiential data will be official statistics from state departments of health listing obstetrical intervention rates at the facility level.

A few days before I discovered this project, I had thought to myself that expecting families needed to have a consumer feedback system in place for maternity care providers in the US, so families could have experiential information and recommendations from other mothers who received care from maternity care providers in their community. So I started searching the web to see if anything like I was envisioning already existed (I'm good at coming up with ideas that are already in the works, and there's no point in reinventing the wheel to find out someone has a better model than me). I was pleased to learn that CIMS has had this project going for the last two years.

They are currently running a pilot of the survey in New York City and plan to make the survey available in August of this year to every women in the US who has given birth in the last 3 years. Women looking for maternity care will be able to view customizable reports once others have completed the survey.

I am pleased to be able to put my interest and skills to work on this project. CIMS is also looking for volunteers across the country who are interested in publicizing the project and its importance for childbearing families. Bloggers, community and online forum participants are encouraged to get the word out to women.

To become a volunteer contact: CIMSGrassroots@yahoo.com.

Harmony and Healing

Be in harmony;
a musical resonance in tune with all that is.
No willing or desiring of particulars
fixated on illusions separate from the flow of life.
Finding this resonance in whatever circumstance we find ourselves in.
Tuning to our adversary,
in accord with those who offend
Not to simply give in and let them have their way.
Confronting the adversary without adding to and provoking new violence.
Skillfully allowing their violence to pass through us.
Without allowing the poison of their intent to contaminate.
To awaken a consciousness within them of their own trouble.
Turning the other cheek to those who strike.
The other cheek
To offer the same would be masochism, weak acquiescence.
Instead, offering new and unexpected oppostion,
standing our ground,
refusing to be a preditable object;
one that is acted upon.
Willing to face the unavoidable friction and conflict.

Where is the harmony? Is it possible when each attempt end in conflict?
First, we must be in harmony with ourselves.
The first possibility to be in harmony with others is to be in harmony with all aspects of ourselves.
Spirit
Mind
Will
and
Body.
No aspect claiming superiority over another,
integrating instead of dominating.
When finding ourselves out of balance within ourselves,
not seeking indulgence, justification or self-blame.
Acknowledging inner discord: fear, panic and hurt,
then finding inspiration
through the manifestations of peace that in within ourselves;
given by the Spirit of love ebbing throughout the universe
Seeking that integration of all part of our whole, leaving nothing out.

Then once again, turning to attune the vibrations of our souls with the souls of those around us.
Finding the strength to balance and be reconciled.
To be in harmony with ourselves before trying to harmonize with the world.

This poem was insprired by a commentary written by Jean-Yves LeLoup, translator of the Gospel of Mary Magdalene into French and then English. His insights into the text of this gnostic gospel turned my thoughts to the discordant environment I found myself in when I was pregnant with my child. My prenatal care, labor support and birth experience created an adversarial environment between my health and my baby's well-being, where I sought to do what the gospels say: "Be in harmony;" "Be reconciled to thy brother;" "And unto him that smiteth thee on one cheek, offer also the other." I struggle to apply these concepts to my birthing experience, feeling that doing any other that fighting would have further traumatized and damaged me. But then to realize that through standing my ground and not being "an object to be acted upon," that I was turning the other cheek as instructed by the Savior.

At the same time I realized that I was not fully in harmony with myself going into birthing my child. I failed to integrate two important aspects of my being: intellectual preparation and spiritual reliance. Why was I shocked at the care I received at the hospital? I did not take the time to read what the maternity care system is like in the US. Knowing what I know now from my crusade as a birth activist could have prevented the heartache I experienced because I probably would have made different choices regarding the care providers I worked with. Also, I went into labor trusting my body and surrenduring to the natural process of birth. I only acknowledged the aspect of will and body in my being, but left out the spirit. Once again I didn't take the time to do what was necessary: to turn to my God who gave me life, the life that is my own and the life of my unborn child. I failed to "Trust in the Lord with all thine heart and lean not unto thine own understanding." If I had done so, I would have been more prepared and stronger in facing the birthing environment and care providers there.

The section of the Gospel of Mary Magadelene that inspired these thoughts ends with the words,

Those who have ears,
let them hear.

I have heard and understood with my whole being and in turn, give thanks to the Being who created me.

Who nurtures a mother?

Who holds a mother and comforts her when down?
Who is there to cup her head in their hand,
so the love from their spirit seeps into hers?

Who holds her up, gives her the strength to stand,
to face another day, to hold anothers hand?

Who is there to listen to the outpouring of her emotions,
to listen with their heart,
and respond with intent to mend?

Who gives her the strength when she doesn't have enough of her own?

Can she run to her own mother, a grilfriend?
The kindly woman next door?
Her children?
Is her only hope God, a spirit who speaks through feelings?
Or can there be reasurrance through touch and an ear tickling with warm breath from a soft voice?

Rough skin against smooth
Arms enfolding, encircling with love?
Heaving breaths and wracking sobs,
Grief contained by the love of another?

Tears dry on wet cheeks
Sobs turning into even breathing
Strands of hair brushed gently away.

Who nurtures a mother?
A husband.

Next Time

I have been carefulling reading and reflecting on Willem's birth story recently and have found some things that I want to change for next time. Those things are the times when things went off course, or I made a decision that I regret now.

First thing:

I'm not going ANYWHERE!

The furthest I may go from my home with be a nice walk on the nature trail or to the shopping center behind my complex. No getting in the car, going to an appointment, going to the hosptial, just to be sent home and go back again.

Next:

Forget the numbers!

I won't worry about dilation, or timing contractions to "prove" to anyone that my labor is for real. As I learned with a newborn, the clock will not be my guide. I will go with the flow of the labor process, trusting my body to do what it knows how to do. I will not impede the progress by stressing out about the numbers like I did last time.

And:

I'm not paying someone to be paranoid for me!

Last time (and I'm still shocked by this fact), I paid an organization to treat me like dirt. I paid them to inflict a trauma on me that led to PTSD and for them to interfere with a process that my body was made to do without "assistance." Their paranoia, time clock, and need to clear the room did not assist me in any way. Also, since I do trust my body to complete the process of birth, I am not going to pay someone to come into my home to worry about "what might go wrong." My husband and I can do enough of that for ourselves. And we can also educate ourselves to learn what to do if that "what if" happens.

This next time, we are relying on our own knowledge and ability to educate ourselves and to have trust in creation. And "if" that something happens, we'll know what to do and where to go to get the assistance needed.


I will also:

Relax!

With Willem's birth, I was so excited to start the marathon that would bring him into my arms that I forgot to rest and conserve strength and energy. I know for next time to take things slowly, as they come, and to sleep when I can. The whole time I was actively doing: focusing, willing my body and baby to hurry up. I know now that is counterproductive and can lead to exhaustion and frustration. Each of the above items will also aid in this goal.

Above all, I will:

TRUST

I am disappointed in myself that I normally approach every life process with faith, prayer, seeking the Spirit of God and when in labor with Willem, I didn't. With Willem's birth, I think I took for granted that the Lord would be my help and I didn't turn to him during the time I was working to bring his spirit child into the world. Next time, I will seek the comfort, guidance and inspiration of the Spirit by seeking a priesthood blessing from my husband who has given me countless blessings in the time we have been married. The birth of a child is a sacred event that I will welcome the great Creator to attend this time and through trust in His process, I be confident in the ability I have been given to become a mother.

The Complaint Process

After a traumatic hospital experience in January of 2007, I have been trying to heal myself and advocate for prevention of traumatic experiences for other women birthing in American hospitals.

First I asked the midwives at the hospital who I would send a complaint to. I was told the nurse manager. I took my complaint to her who said it would go to an internal review board with the midwifery practice at the hospital and their supervisory obstetrician. I wrote a letter to them detailing the outcomes of the care they provided me. It was 5 months from the initial phone call to the nurse manager to the response sent from the review board.

The response I got back ignored my case of PTSD and that it was caused by their treatment. Instead, I was told that I had "received a clinically appropriate standard of care."

I wrote back pointing out this discrepancy in handling my complaint. I was told that my case was being forwarded to the Grievance Committee conducted by the Risk Management department of the hospital. I was also given the contact information for the Joint Commission and the State Department of Health. Both have official complaint processes for patients and family members who believe that their care was not conducted well for whatever reason.

Currently, a year after the initial trauma, I have complaints lodged with the Joint Commission, my state department of health and the risk management department of the hospital. I'm waiting to hear what they will say. And who knows if my complaint with have an effect.

For others interest in making a writen complaint about care they have received go to:
Joint Commission Complaint Form

The Joint Commission is a non-profit accredidation and quality assurance organization for over 15,000 hospitals and medical care centers in the US. They have some clout in getting hospitals to change their policies.

I will update when further progress has been made.

I Came out With a Baby

I went into a concentration camp and came out


with a baby

I was herded in with the scores of others
We were blinded by our fear
The fear of "what if"
We trusted
The trust of "dr knows best."
The doctors here weilded power, might.
They had the power for pain, withholding relief.
Intensifying pain with the turn of a dial.
Inserting tubes, needles, instruments, hands.
Cutting, pulling, ripping, tearing.
Restraints and isolation
Mad scientist doctors testing new drugs and procedures
Without consent without informing
Just doing
Not knowing the risk.
Let's see what this does...
Evil cackles echo in hermetically sealed vaults
Vaults filled with super germs, flesh eating bacteria
Lurking to be introduced into the secret fleshy places.

Brainwashing, lectures.
This is what is coming to meet you.
We will do this.
You have no say.
We can do this.
We will do this.
You can't stop us.
Time to go in.
Time is up.

Resistance is futile.

My time was up.
It was my turn.
All the others before me had passed through.
So I went.
The threats were enough.
The looming dominance and control.
Emotional manipulation was enough.
There was no need for tests.
The fight to protect my body from
the hands
the instruments
the tubes
and needles.

I came out scarred.
No physical traces.
Only fear, trauma and distrust.

And a baby.

My experiences of PTSD after childbirth

Some of my friends may have noticed that I have not been myself in the last few weeks. There are a lot of reasons for this, some of which I understand and I'm sure some I don't. Since Willem was born, I have been plagued with memories from his birth. I have experienced flashbacks where memories loop over and over again and I cannot stop them. I experience flashes of anger as I recall the way I was treated by the hospital staff. I can recount the ways in which I felt violated, belittled, and ignored. These feelings are strongest when I'm trying to fall asleep at night so I have spent many times (such as this one) awake, struggling to fall asleep but I can't because I cannot get these thoughts out of my head.

For many months, I couldn't talk about my experiences or even birth in general without a flood of memory. My husband and I would spend hours whenever the topic came up (which was frequently) going over the time when I was laboring to give birth to our son. A couple of times, my sleepless nights resulted in my husband being awoken by my crying and then together we would talk through the whole experience again.

I was sad and hurt because of the treatment I received but afraid that other women everyday since then, maybe even as I'm writing this, are experiencing the same type of degradation and disrespect. I don't want that to happen to another woman and so I know that some action is needed to prevent it.

I began considering becoming a midwife so I could ensure that I never was as insensitive to a laboring woman's needs as the midwives who were responsible for my prenatal care, labor and delivery. I realized that they weren't responsible for my care and my ability to give birth. They were supposedly assisting me in my responsibility as a woman, and a new mother. I wanted to be sure that I was also a help and a support, not an authoritarian, imposing figure of punishment and manipulation. I quickly realized that I am not prepared or willing for a complete career and educational change as going into the medical field from child development. But I realized that the role of a doula or labor assistant would be a complimentary type of family and parenting education to the type of educator that I am already trained to be. I started looking into the educational requirements that a doula needs to be certified and found that a strong understand of the physiological process of birthing as well as the ability to comfort and support a laboring woman in the way she feels she needs to be comforted is necessary. So I started researching and learning about the process of birth, how it is best accomplished without medical interventions and "aggressive management."

In this period of learning and thinking of changing direction in my education, I began to be more verbal about my experience which I realized could be considered traumatic since I was still dealing with negative emotional effects from it. I joined some online groups for women who dealt with traumatic birth experiences and found that I was not alone. I knew I was not depressed because I only became angry or hurt when recalling those events, and did not feel down at any other time. In my research and learning, I discovered that it is not uncommon for women who endured difficult birth experiences to display symptoms of Post Traumatic Stress Disorder. I read some the definitions and descriptions and found that I do display many of those symptoms. Since realizing that, it seems that a Pandora's Box of recollection and feeling has been opened. The thoughts and memories that once plagued me intermittently now wouldn't go away. They were always there, on the periphery of every thought and action of my day. I had a diagnosis, a reason, an explanation for why I was broken and dysfunctional.

I was able to give birth to my beautiful almost 7 pound baby without drugs and in a hostile environment where I had people telling me that I couldn't give birth without drugs, that I would need to be induced, that they—"the experts", the doctors, midwives and nurses—could take over and make my body do what it couldn't do on its own. But I believed that my body was capable of giving birth safely, naturally, without the "help" of interventions that could potentially harm me or my baby. And because I was able to be strong, to stand my ground and endure, I was treated that there was something wrong with me. That if I didn't receive their "help," my baby would be hurt, or killed or that I could die. And then I come away from that experience knowing that I can allow a baby to grow within my body and then pass through my body as he/she enters the world, feeling vindicated. I learned that it can be done, that it's not scary, or unbearable. But I was still scarred. By people who instead of helping me though a time of tremendous effort and concentration did everything in their power to make it harder for me, by insisting I remain in positions that are empirically shown to be ineffective and more difficult for a laboring woman, by pushing drugs and interventions that are shown to increase the occurrences of complications and needed interventions, when I could do it on my own. I needed people who would offer me confidence, strength, encouragement and measures to help me be more comfortable to make the process easier. Instead they made the whole experience harder and as I come to find out—traumatic.

And then there are other issues. Why am I having such a hard time putting this experience behind me when other women have experienced much worse? Giving birth to a child is always an emotional event and every woman I know has been able to put it behind her. No one that I know of has ever "suffered" long lasting emotional effects like I have. So what's wrong with me? This sense of inadequacy is probably why its taken so long for me to start talking about this with other women, especially other women who have given birth and are mothers.

Another thing that has kept me from talking about this experience (outside of the people who were there) is that it's been too painful for me to do so. I still have a hard time talking about it without breaking down, yelling, crying and having the bitter resurgence of anger rise up within me. I've even tried to refrain from talking about it with my husband and my friend who acted as my doula because I don't want to annoy or alienate them. I don't want to expose people whom I love and care for to a flood of negative emotion, anger and drama. I'm also especially cautious to share my feelings with friends who have not yet had children or encountered the mentality of doctors and hospital staff when it comes to pregnancy and birth. I don't want to scare them.

A couple of weeks ago, I was finally able to express to the hospital where Willem was born that their staff may have been responsible for the maltreatment of me as a patient. In telling my story to the nurse manager, I was very proud of myself that I was able to remain calm. Upon hearing my description of the events, she promised me that she would call a review board with all the midwives and supervisory OBs to review my case as it sounded to her like there was some breech of hospital policy and violations of my rights as a patient. I have been waiting to hear about the results of that meeting (it will be in the form of a letter that will tell me nothing, but I still want to know that it happened). In the last two weeks, my emotional distress has reached a new height causing me to act in ways that I wouldn't typically act.

I have become very vocal about distrust for doctors, especially OBs, midwives and nurses and the medical interventions they routinely offer to laboring women, as well as my disappointment in the number of women who trust their doctors without understanding the potential risks of those interventions. I had learned some about the side effects of interventions in childbirth and knew that I didn't want to expose myself or my baby to them. I also looked at childbirth in a spiritual way—women were created by a Divine Creator who made women's bodies to be capable of giving birth without medical interventions and put medical technology on the earth to help treat women and babies in case something went wrong. I believe in the power of women to carry, nourish and birth their babies and I was sad to hear of so many of my sisters who were so scared of the pain of childbirth and instead opted for an "easier" way. Even though that easier way often leads to complications that make the whole process more difficult and potentially damaging to mothers and babies. Some women I talked to experienced stalled labor, C-sections, seizures, long term pain and difficulties, had babies born who were not breathing or had to spend weeks in the NICU because of the "care" they received. I am worried about my friends and the countless other women who are not informed of the potential side effects of standard ..:namespace prefix = st1 ns = "urn:schemas-microsoft-com:office:smarttags" />OB care during childbirth. Since I had a difficult experience without any of that, I just don't want anyone to experience anything similar or worse to my experience.

I feel that I was spared from a set of problems that I would rather do without. Because of the curvature of my spine (scoliosis) I am pretty confident that an epidural would not have been able to be placed properly in my spine so the likelihood of nerve damage and the resulting complications were high for me. I consulted with my chiropractor on this and was validated in my concern. Her professional recommendation was that it was a good thing that I didn't get the epidural.

Who knows is this explanation is helpful in explaining my actions of the last few weeks. I am seeking help to deal with the PTSD. I start meeting with a psychologist on Wednesday and hopefully, I'll be able to let go of the anger and hurt and I feel. I want to be able turn that bad experience into something good and channel my energies into making birthing more comfortable and safer for other women. I also know that I can turn to my Savior to find comfort and peace, where he can help me let go of my grief because he has suffered it for me. Unfortunately, it's not as simple as it is to say it. There is a process that I need to work though and I am making progress and starting to be able to move forward.

Many of my current decisions are being based on that experience to make things better. The main reason why I am seeing a chiropractor is to reduce the curve of my spine so my next labor will not have as much back labor. My current focus in my scripture study is to understand more about the resources God intends to use for our health and well-being, part of that the use of drugs in childbirth. As I also talked about, I'm studying a new area for my education as I am working to become a doula. I'm also starting research on PTSD that occurs after a traumatic birth experience and how it can be prevented in the future. One of the big answers to that question is by having supportive, sensitive birth attendants (doulas in particular), which is a big reason why I'm heading in that direction.

I hope I have not offended anyone with my actions of the last few weeks. I am trying to make sense of a difficult period of my life and that is why I've written this explanation—to explain to my friends why I've said and done some of the things that I have. I hope you can understand.

The Midwife Search

After my experience with CNMs (Certified Nurse Midwives) in a hospital setting, I feel very strongly that I cannot plan another birth in a hospital. That leaves me with two other settings: a dedicated birth center or at home. The attendants at births in those settings are midwives, whether LMs or CNMs. They are also much more likely to support the Midwifery Model of Care. That's the standard of care I thought I would be getting from the UW Midwives program, but I was mistaken and suffered because of my own ignorance.

This time around, I am interviewing potential midwives BEFORE I get pregnant so I don't feel any pressure to pick one because I have a time bomb in my uterus with a deadline. I started doing internet searches in my area. Living in Seattle(home of the pioneering Seattle Midwivery School), there are lots of midwives around.

Most out of hospital midwives will provide a free consultation appointment where a woman can interview with questions and get a feeling for a particular midwife's philosophy and style. I learned its important to be able to trust a midwife at the vulnerable time during labor and birth where a woman needs loving support and is easily open to suggestion.

Here is a sample of the questions I asked:

How do you employ the Midwifery Model of Care in your practice?

How do you empower women?

What positions do you suggest for birthing?

How do you support a laboring woman?

If a transfer is needed, what do you do? Where to?

What complications necessitate a transport?

Describe the prenatal care.


I interviewed four midwives initially and got enough information where I felt I could compare and choose of those four which I felt most comfortable. Tentatively, I have chosen one who also provides Naturopathic care to families and children. However, the search does continue while I continue to think through my wants while weighing what I feel is safest for me and my next baby.

Willem's Birth Story

Thursday night, sex is what did it. Within a couple of hours the contractions started (around 1:30am). I tried to sleep but gave up at 5:30 when I woke Peter up and told him what was going on. We waited until my appt at 11:00 to give me more time to progress. At the appt, I was at 3 cm. That's when they told me I could go up to L&D and then a few minutes later found out they were full so they were sending me home. At that point, I just wanted to be in one place where I could get comfortable. I definitely had the urge to hole up so I could relax and just focus. I wasn't comfortable at home because it is such a small space that I felt trapped, my bed wasn't comfortable, the bath is too small, etc. I think if they had let me get comfortable at the hospital, things would have progressed a whole lot faster. But I got stressed out and I think that really slowed me down.

At 4:00pm Friday I went back to the hospital. My contractions were closer together and stronger but I was only at 3 1/2 cm. I was comfortable, relaxed and happy to finally settle in somewhere. I was looking forward to the bath and just focusing on the Hypnobirthing techniques. I got about 3 hours of that and then the evil midwife Cindy started harassing me about "moving things along." I was given a few options, none of which appealed to me. I might have considered having my water broken but I felt like I needed to progress more on my own. I was given an hour to "wait and see." After the hour was up, they came back and told me that my only options included drugs. That just pissed me off.

I was told that I could 1) get my water broken and started on a pitocin drip. 2) be given sleep medications and go home. 3) be put on a morphine drip and stay in the hospital. What did I want? To be left alone and stay in the hospital so I could focus on the Hypnobirthing techniques. When I made that clear, the chief resident came in and flat out told me that all my options had been taken away and that I needed to go home. No "come back when your water breaks" nothing. I was PISSED. To add insult to injury, the medical charts from that day said that I was told to leave but left before any direction or follow-up could be given. Hello!? They didn't offer it.

The next few hours at home were some of the worst of my life. All the reasons why I wasn't comfortable before were so much worse. The contractions were stronger and closer together and most of them were in my back at that point. I hadn't slept in 24 hours, I was stressed and scared and panicky after the conflict with the hospital staff. Laying down was miserable because I was having back contractions, my bed was too soft to be on my knees and that was making the back contractions worse, flat was bad, on my side was bad. The birthing ball was okay but my legs were so tired that I couldn't keep myself up. I called my friend who was acting as a doula (she had been there at the hospital with us) and she came back. Without her, I don't know what I would have done. I was scared and Peter was scared. She helped us figure out some things to do. I still can't believe the hospital sent me home then without any support. When I called to ask for some help, the only thing I was told was I could come in and they could augment my labor (i.e. breaking the water and pitocin) and received no sympathy. It was either I go in and let them take over or I stay at home. This was about 2 am. By then I had been in labor for 24 hours and I felt like I had been kicked out on the street with no one other than my friend to turn to. It was a hellish experience and I hope I'm not scarred for life. I was so stressed out by then I started vomiting. I seriously started considering giving birth at home but felt like the conditions I was in was second world at best. For goodness sakes, Peter and Shawnette were having to heat water on the stove to put it into my bath, the only place where I was semi-comfortable.

All through this time, I was able to use the Hynobirthing techniques which was basically breathe through each contraction and visualization labor progressing, my cervix opening and the baby moving down. Those mental cues weren't as powerful as I think they should have been because of all the stuff I described in the paragraph above. The breathing kept me sane and Shawnette and Peter helped me focus on that.

By 7 am Saturday, my contractions were much stronger and closer together. I was completely distrusting of the hospital but couldn't keep going like I had been so I basically resigned myself to letting them take over. I went into the hospital at 8 am and found out that I was 5 cm dilated and fully effaced. That was disappointing and I would have been very discouraged if it weren't for the midwife and nurse (the good Cindy) who were on the shift. They were excited to help me and wanted to make sure that I was able to get comfortable. Everything was 1, 000 times better with those two looking out for me. They let me progress for another few hours and then suggested that they could break my water so I could get to the next phase of labor. After contracting furiously for 35 hours, I was open to that, especially since there was no mention of pitocin.

They broke my water at 11:30 Saturday morning. Things really started picking up from there and by 2:00 pm I was fully dilated. I was exhausted but was much more relaxed than I had been in the previous day. I was still breathing through contractions pretty well.

I should probably mention that Willem was doing fine through all of this. His heartrate was strong and stable. I was surprised to find out that he was sleeping through some of my strongest contractions.

At 2:00, I felt like I wanted to start pushing. I expressed that to the nurse and midwife who insisted that I move from my comfortable spot in the tub to the bed. The nurse cajoled and insisted on having me lay down and be monitorred. I was bothered and annoyed and told her repeatedly to take the monitors off. They were making me uncomfortable and I couldn't move into a position that I felt I needed to be in.

In the Hypnobirthing method, pushing is not encouraged and a technique called "breathing the baby down" is used. But because of my exhaustion and the stress of fighting off the nurse and recalling the stress of the day before, I just couldn't figure out how to do it, so I did the only thing I knew I could do- push, in the position they wanted me to be in, on my back, with my legs being held by Peter and the nurse. After 45 minutes of pushing, he was out. I had always heard that after the head is out, that it takes another push or two to get the rest of the body out. Nope, not with this kid. He went flying out in that last push, his head and everything else flying at a surprisingly high velocity. Sad for Peter, he missed taking a picture of the baby's first breath because he was moving so fast. Pushing intimidated me and my intensity in that situation intimidated me. I didn't feel like myself and I still can't describe what it was like. The best I can come up with is primal. The scream that tore through my body was not one of pain, but of sheer effort and the fear that I was actually expelling a child from me and with a vague sense of familiarity like the scream accompanying an intense orgasm.

So after 38 hours of labor, Willem was born at 2:45 pm Saturday afternoon. At birth, he weighed 6 lbs. 13/4 oz. and was 20 1/2 inches long. The only medical assistance I got was having my water broken, something looking back on I regret. How I know that AROM rarely does not speed labor along in statistical tests and wouldn't have have affected my labor in any substantial way.

I did tear a little bit in a couple of different places but I was assured repeatedly that its not that bad and only required one or two stitches in each place. At the time I asked if it was neccessary for the stitches because I would have preferred any small tears to heal on their own. The midwife responded that they probably weren't neccessary but she was going to do them anyway. Before I had a chance to refuse, she had started. I laid back, again, exhausted and tired of fighting and let the whirlwind of activity take place as my baby was taken from my arms and kept away from me while a needle was being pulled through my flesh over and over.

I stayed in the postpartum ward at the hospital on Saturday night but got really tired of the constant monitoring and interruption. The bed was too short for me to get comfortable and I was really looking forward to going home. I'm so glad that home was appealing to me because after Friday night... I was worried that I never want to go back there. Now its the hospital that I never want to go back to.

I feel like I was treated unfairly and unprofessionally by the hospital staff on Friday and am so glad (and the hospital should be too) that I got better care on Saturday, when even then my rights were violated when treatment was forced on me when I was clearly voicing or even before I could voice my refusal.

Since then I've learned that the care I received was standard procedure at that hospital and at most hospitals in the United States. I have experienced months of Post Traumatic stress from that ordeal where I feel like control of my body was taken away from me and my freedom restricted. One reaction I had to that experience was wanting to have another baby as soon as possible to do it better next time, like a do-over. And the next time will be out of hospital with either a hands off midwife, midwife on call for an emergency or completely unattended by midwife or doctor.